ICD-9-CM 2009 Changes

This year's ICD-9-CM updates are numerous and broad reaching. Here are the stats:

Volume    1
New          367
Updated   60
Invalid     25 (no deletions; all codes became non-specific)

Volume    3
New         60
Updated  34
Invalid    5 (no deletions; all codes became non-specific)

In addition to the code changes there are over two hundred pages of changes to the official ICD-9-CM coding manuals. Let's look at some of the groups of changes in Volume 1 to see how the changes may affect your particular practice.

Infectious and Parasitic Diseases
24 new codes covering Staph. aureus, prion diseases, pox viruses, and amebic diseases.

73 new codes that comprise malignant neoplasm in a transplanted organ, relapse codes for multiple myeloma and leukemias, benign and malignant carcinoid tumors, and post-transplant lymphoproliferative disorder.

Endocrine, Nutritional, and Metabolic Diseases, and Immunity Disorders
28 new codes for secondary diabetes mellitus, androgen insensitivity, hungry bone syndrome, and variants of graft-versus-host disease.

Diseases of Blood and Blood Forming Organs
1 new code for heparin induced thrombocytopenia.

Mental Disorders
No new codes.

Diseases of Nervous System and Sense Organs
68 new codes covering idiopathic peripheral autonomic neuropathy including carotid sinus syndrome; cluster, tension, traumatic, and syndrome headaches; extensive changes to the migraine headache classifications; accidental puncture of dura during a procedure; retinopathy of prematurity; plateau iris syndrome; and pingueculitis.

Diseases of the Circulatory System
1 new code for coronary atherosclerosis due to lipid rich plaque.

Disease of the Respiratory System
3 new codes including methicillin resistant pneumonia due to Staphylococcus aureus, malignant pleural effusion, and other non-TB related effusion.

Diseases of the Digestive System
7 new codes comprising eosinophilic digestive tract inflammations, anal dysplasia, and autoimmune hepatitis.

Diseases of the Genitourinary System
12 new codes including degrees of hematuria, breast and reconstructed breast disorders, and variants of vulvodynia.

Complications of Pregancy, Childbirth, and the Puerperium
19 new codes for variants of cervical shortening, fetal hematologic conditions, fetal conjoined twins, and maternal and fetal complications due to in utero procedures.

Diseases of the Skin and Subcutaneous Tissues
17 new codes including erythema multiforme variants and exfoliation due to an erythematous condition.

Diseases of the Musculoskeletal System and Connective Tissue
10 new codes for pressure ulcers and unspecified soft tissue disorders.

Congential Anomalies
3 new codes for stress fractures.

Certain Conditions Originatin in the Perinatal Period
8 new codes for newborn affected by maternal procedures and stages of newborn necrotizing enterocolitis.

Symptons, Signs, and Ill-Defined Conditions
29 new codes including variants of fever or hypothermia, functional quadripelgia, functional incontinence and other urinary symptoms, satisfactory cervical smear lacking the transition zone, abnormal cervical glandular Pap smears, and abnormal anal glandular Pap smears.

Injury and Poisoning
8 new codes comprising ventilator assisted pneumonia and other respiratory complications, disruption of wounds, extravasation of vesicant agents, and other infusion reactions.

Supplementary Classification of the Factors Influencing Health Status and Contact with Health Services
56 new codes including staph. aureus carrier, prophylatic use of modulators of estrogen or its receptors, history of MRSA, history of fractures or other musculoskeletal disease, history of in utero procedure, history of traumatic fracture, reproductive technology assisted pregnancy, pregnancy with history of in utero procedure during previous pregnancy, prenatal screenings, renal dialysis, transplanted organ removal status, tPA administration at other facility, wheelchair dependence, breast reconstruction encounter after mastectomy and other plastic surgery aftercare, family disruptions, military deployment status, hazardous chemical exposures, history of chemotherapeutic modalities, acquired absence of cervix and/or uterus, and suspected maternal or fetal conditions not found.

Supplementary Classification of External Causes of Injury and Poisoning
No new codes.

Dr. Carter's Corner
Darren Carter, MD, founder and President of Provistas, has a personal commitment to alleviating uncertainties in the health compliance environment. He has authored dozens of articles, presents to professional and hospital associations, serves on several editorial boards, and provides consulting and expert witness testimony.